弥散性血管内凝血DIC.pptx
弥散性血管内凝血
Chapter11中山医学院病理生理教研室邓宇斌
DIC防治的病理生理基础DIC的功能代谢变化（病理生理变化）DIC的分期和分型促进DIC发生发展的因素（诱发困素）DIC原因和发病机制DICEDCBAF
第一节概述血液的凝固与抗凝流动性血液运输载体方向性内（Ⅻ）凝血系统凝血外（Ⅲ）血小板：粘聚释
凝↑／抗凝↓→栓塞1失衡2凝↓／抗凝↑→出血倾向3DIC的概念4出血5病因微血栓后休克6致凝继发纤溶亢进果栓塞7溶血8120种病：感染、肿瘤、产科意外9
DICischaracterizedbythe1activationofthecoagulation2systemwithresultant3consumptionofavarietyof4coagulationproteinsandplatelets,5whichresultsinhemorrhagic6diathesisandischemicinjuryto7varioustissues.8Introduction
BloodCoagulationItispropagatedbyanenzymaticeventstermedcoagulationcascade.ContactfactorsandtheintrinsicpathwayTissuefactorandextrinsicpathway
substancestermedplasmaprecursor(plasminogen)ofplasmin,aproteolyticplasminogenactivators.bytheactionofvariousItistheresultoftheactionenzymeproducedfromaninert2.Fibrinolysis
HumoralplasminogenactivatorsTissueplasminogenactivatorsFibrinorfibrinogendegradationproductsFDP(Significantbiologicalactivity)FragmentsX,YandE(potentantithrombins)FragmentsYandD(inhibitfibrinpolymerization)
aⅡaⅢaPCAPCTM+Ⅱ灭活PS(+)C4bC4bPS(-)
酶纤溶FDP酶ATPC抗APCTM+Ⅱa凝PSPGI2VECTM
发病原因及机理VEC广泛受损原因感染炎症、免疫损伤（抗磷脂综合征）高低温、放射损伤缺血缺氧酸中毒第二节DIC的病因发病学
septicemia(2)severetraumaobstetricaccidents(4)shockacuteDICmalignanttumorsretaineddeadfetussubacuteDICgianthemangiomasystemiclupuserythematosus(SLE)chronicDICEtiologyofDIC
抗凝↓VEC释放Ⅲ胶原暴露表达TM↓→